scholarly journals Telocytes and Cajal cells distribution in renal pelvis, ureteropelvic junction (UPJ), and proximal ureter in normal upper urinary tract and UPJ obstruction: reappraisal of the etiology of UPJ obstruction

2020 ◽  
Author(s):  
M. Wishahi ◽  
A. A Mehena ◽  
H. Elganzoury ◽  
M. H. Badawy ◽  
E. Hafiz ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Pelvis ◽  
Upper Urinary Tract ◽  
Ureteropelvic Junction ◽  
Upj Obstruction ◽  
Cajal Cells ◽  
Proximal Ureter

Utility and Diagnostic Accuracy of Ureteroscopic Biopsy in Upper Tract Urothelial Carcinoma

2013 ◽  
Vol 137 (3) ◽  
pp. 400-407 ◽  
Author(s):  
Vishal Vashistha ◽  
Ahmad Shabsigh ◽  
Debra L. Zynger
Keyword(s):  
Urinary Tract ◽  
Diagnostic Accuracy ◽  
Sample Size ◽  
Urothelial Carcinoma ◽  
Renal Pelvis ◽  
False Negative ◽  
Upper Urinary Tract ◽  
Ureteropelvic Junction ◽  
Endoscopic Biopsies

Context.—Ureteroscopic biopsy is the gold standard for the histopathologic diagnosis of urothelial carcinoma of the upper urinary tract. Objective.—To assess the accuracy of endoscopically obtained biopsy samples in diagnosing, grading, and staging urothelial carcinoma and correlate diagnostic findings to biopsy sample size. Design.—We retrospectively reviewed endoscopic biopsies of the ureter, renal pelvis, and ureteropelvic junction from 2008 to 2011. Biopsy diagnoses that were discordant with follow-up pathology and/or ureteroscopic impression were rereviewed and samples were immunohistochemically analyzed. Results.—Endoscopic biopsies (n = 118) yielded a sensitivity of 85.4% for the ureter (n = 79), 77.8% for the renal pelvis (n = 37), and 100% for the ureteropelvic junction (n = 2). A specificity of 100% for all locations and a diagnostic accuracy of 98.3% were identified. The median sample size was 0.3 cm for true positives, 0.3 cm for true negatives, and 0.2 cm for false negatives with no statistical significance. We found that 87.1% of tumors diagnosed on biopsy had concordant grade and 60.0% had concordant pT stage with follow-up surgical resections (n = 43) and biopsies (n = 24). Biopsy samples with concordant tumor grades (mean = 0.6 cm) compared with follow-up resection were larger than biopsy samples with discordant grades (mean = 0.3 cm) (P = .04). Conclusions.—Though highly specific, endoscopic biopsy does provide a significant false-negative rate owing to both sampling and diagnostic errors when assessing the upper urinary tract for urothelial carcinoma. Tumor grading is accurate, particularly with larger tissue samples, but tumor staging is unreliable.

scholarly journals Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Richard H. Siderits ◽  
Jared Fingerman ◽  
Anup Hazra ◽  
Cheryl Rimmer ◽  
Marc Colaco ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Urinary Tract ◽  
Renal Disease ◽  
Renal Pelvis ◽  
Chronic Renal Disease ◽  
Squamous Metaplasia ◽  
Upper Urinary Tract ◽  
Muscularis Mucosa ◽  
Chronic Infections ◽  
History Of

Metaplastic changes in the urothelium of the upper urinary tract are relatively infrequent. Metaplasia may present as either squamous or less often glandular differentiation. The process may be associated with chronic inflammation or associated chronic infections. There may be malignant transformation to either squamous cell carcinoma or adenocarcinoma. The demarcation of the metaplastic process in the minor calyces has not been well documented to date. We report the case of a 74-year-old female patient who presented with a history of chronic renal disease and acute pyohydronephrosis. The patient underwent a nephroureterectomy which revealed keratinizing desquamative squamous metaplasia throughout the renal pelvis and upper urinary tract with abrupt termination of metaplasia at the junction of the renal pelvis and the minor calyx (pyramidal zone). Immunohistochemical evaluation documents metaplastic urothelium stained positive for CK5, before converting sharply to simple cuboidal epithelium in the minor calyx (pyramidal zones) which stained positive CK7. At the junction of the metaplastic components and low cuboidal lined minor calyceal surfaces, the underlying stroma showed loss of ureteral muscularis mucosa with transition to renal parenchymal type stroma. We believe that this observation is unique and potentially relevant to the etiology and pathophysiology of pelviceal metaplasia.

scholarly journals A DNA adductome analysis revealed a reduction in the global level of C5-hydroxymethyl-2′-deoxycytidine in the non-tumoral upper urinary tract mucosa of urothelial carcinoma patients

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Yuto Matsushita ◽  
Yuji Iwashita ◽  
Shunsuke Ohtsuka ◽  
Ippei Ohnishi ◽  
Takashi Yamashita ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Dna Adducts ◽  
Renal Pelvis ◽  
Renal Cell ◽  
Renal Cortex ◽  
Upper Urinary Tract ◽  
Urinary Tract Urothelial Carcinoma

Abstract Background DNA adducts, covalent modifications to DNA due to exposure to specific carcinogens, cause the mispairing of DNA bases, which ultimately results in DNA mutations. DNA methylation in the promoter region, another type of DNA base modification, alters the DNA transcription process, and has been implicated in carcinogenesis in humans due to the down-regulation of tumor suppressor genes. Difficulties are associated with demonstrating the existence of DNA adducts or chemically modified bases in the human urological system. Apart from aristolochic acid-DNA adducts, which cause urothelial carcinoma and endemic nephropathy in a particular geographical area (Balkan), limited information is currently available on DNA adduct profiles in renal cell carcinoma and upper urinary tract urothelial carcinoma, including renal pelvic cancer and ureteral cancer. Method To elucidate the significance of DNA adducts in carcinogenesis in the urothelial system, we investigated 53 DNA adducts in the non-tumoral renal parenchyma and non-tumoral renal pelvis of patients with renal cell carcinoma, upper urinary tract urothelial carcinoma, and other diseases using liquid chromatography coupled with tandem mass spectrometry. A comparative analysis of tissue types, the status of malignancy, and clinical characteristics, including lifestyle factors, was performed. Results C5-Methyl-2′-deoxycytidine, C5-hydroxymethyl-2′-deoxycytidine (5hmdC), C5-formyl-2′-deoxycytidine, 2′-deoxyinosine, C8-oxo-2′-deoxyadenosine, and C8-oxo-2′-deoxyguanosine (8-OHdG) were detected in the renal parenchyma and renal pelvis. 8-OHdG was more frequently detected in the renal pelvis than in the renal cortex and medulla (p = 0.048 and p = 0.038, respectively). 5hmdC levels were significantly lower in the renal pelvis of urothelial carcinoma patients (n = 10) than in the urothelium of patients without urothelial carcinoma (n = 15) (p = 0.010). Regarding 5hmdC levels in the renal cortex and medulla, Spearman’s rank correlation test revealed a negative correlation between age and 5hmdC levels (r = − 0.46, p = 0.018 and r = − 0.45, p = 0.042, respectively). Conclusions The present results revealed a reduction of 5hmdC levels in the non-tumoral urinary tract mucosa of patients with upper urinary tract urothelial carcinoma. Therefore, the urothelial cell epithelia of patients with upper urinary tract cancer, even in non-cancerous areas, may be predisposed to urothelial cancer.

scholarly journals Transitional cell carcinoma of the upper urinary tract: a puzzle

2020 ◽  
Vol 7 (10) ◽  
pp. 1585
Author(s):  
Soumish Sengupta ◽  
Supriya Basu ◽  
Kadambari Ghosh
Keyword(s):  
Urinary Tract ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Transitional Cell ◽  
Expectant Management ◽  
Upper Urinary Tract ◽  
Urinary Tuberculosis ◽  
Gross Haematuria

Transitional cell carcinoma (TCC) of the upper urinary tract has a puzzling presentation. This is a case report of a 44 year old male with history for smoking 20 pack years presenting with cough, haemoptysis and microscopic haematuria. His sputum was positive for acid fast bacilli. He was treated as pulmonary tuberculosis (PTB) but had gross haematuria a month after initiation of anti-tubercular drugs (ATD). He was investigated with computed tomography (CT) imaging and was found to have thickened renal pelvis and ureter. It was initially thought as a case of genito-urinary tuberculosis (GUTB). Expectant management for gross haematuria failed. The patient was stabilised and taken up for open nephroureterectomy under general anaesthesia (GA). Histopathological report suggested it to be high grade TCC of the left renal pelvis extending to upper ureter. He did well with completion of ATD. He was not started on adjuvant chemotherapy for fear of exacerbation of PTB. He is under regular and uneventful follow up in the outpatient department (OPD).  

scholarly journals Metachronous Primary Adenocarcinoma of Distal and Proximal Ureter within Two Years

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Dominik Abt ◽  
Gautier Müllhaupt ◽  
Livio Mordasini ◽  
Pierre André Diener ◽  
Hans-Peter Schmid
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Upper Urinary Tract ◽  
Primary Adenocarcinoma ◽  
R0 Resection ◽  
Rare Entity ◽  
Distal Ureter ◽  
First Case ◽  
Proximal Ureter ◽  
Low Incidence

Primary adenocarcinoma of the upper urinary tract, particularly of the ureter, is an extremely rare entity. We are reporting on the first case of metachronous appearance in one patient. The 71-year-old man underwent partial ureterectomy (R0 resection) for primary adenocarcinoma of the left distal ureter. 3 years later, nephroureterectomy had to be performed because of metachronous primary adenocarcinoma of the left proximal ureter. Extensive examinations revealed no evidence for further malignancies at both times. Primary adenocarcinoma of the upper urinary tract is rare but should be kept in mind, especially in patients with chronic inflammation and urinary tract obstruction. Due to the low incidence, there is a lack of data regarding its pathogenesis, diagnosis, and optimal treatment.

Multifocal Synchronous Upper Urinary Tract Carcinosarcoma (Sarcomatoid Carcinoma) With Rhabdomyoblastic Differentiation

2019 ◽  
Vol 27 (5) ◽  
pp. 547-552 ◽  
Author(s):  
Kosuke Takemura ◽  
Toru Motoi ◽  
Akiko Tonooka ◽  
Nobuaki Funata ◽  
Yasukazu Nakanishi ◽  
...  
Keyword(s):  
Stem Cells ◽  
Urinary Tract ◽  
Adjuvant Therapy ◽  
Urothelial Carcinoma ◽  
Renal Pelvis ◽  
Sarcomatoid Carcinoma ◽  
Upper Urinary Tract ◽  
Radical Nephroureterectomy ◽  
Visceral Metastases ◽  
Neoplastic Stem Cells

Carcinosarcoma of the upper urinary tract is very rare. In this article, we report a case of upper urinary tract carcinosarcoma with rhabdomyoblastic differentiation showing distinct transition between the epithelial and mesenchymal components confirmed by morphology and immunohistochemistry. An 81-year-old female underwent radical nephroureterectomy under the diagnosis of left ureteral urothelial carcinoma (UC). Multiple invasive tumors showed combined histology with UC and rhabdomyosarcomatous elements (pT2-ureter and pT3-renal pelvis, pN0, u-lt0, ly0, v0, RM0). Each element demonstrated typical epithelial or mesenchymal staining patterns (positive for AE1/AE3 in the former and positive for vimentin and myogenin in the latter). Notably, immunohistochemical transition patterns of GATA-3, p63, SOX2, and myogenin between UC and rhabdomyosarcomatous elements were observed, implying possible involvement of neoplastic stem cells in the process of carcinosarcoma formation. The patient did not receive any adjuvant therapy and eventually succumbed to multiple visceral metastases (lungs and liver) at 11 months postoperatively. No autopsy was performed.

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